AB1736-PARE CHALLENGES FOR PATIENTS WITH RMD’S IN BULGARIA DURING THE COVID-19 PANDEMIC
Authors: A. Marinkov, Z. Batalov, R. Karalilova, A. Batalov, B. Boteva
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The Covid-19 pandemic has put patients with rheumatic diseases in front of a number of obstacles that had to be solved together with Bulgarian rheumatologists. The lockdowns and restrictive measures have made it difficult for people with rheumatic diseases to have access to timely hospital and pre-hospital care. A number of digital solutions have been implemented to address these issues. <h3>Objectives</h3> To highlight the problems that patients with rheumatic diseases had during the Covid-19 pandemic; access to rheumatologists and the effectiveness of hospital and pre-hospital care during the pandemic, access to treatment, changes of treatment; communication between physicians and patients, the impact of the pandemic on work, social contacts, hobbies. <h3>Methods</h3> An anonymous survey was conducted online and by telephone. The survey was developed by Medical university, Plovdiv, University hospital "Kaspela":, Plovdiv, Bulgarian Association for Musculoskeletal Ultrasound, Bulgarian organization for people with rheumatic diseases; Association for patients with autoimmune diseases. Number of participants: 1205 patients with RMD's. Age range: 18-82 <h3>Results</h3> Face to face meetings with doctors have been limited during the pandemic. Visits to the rheumatologist's office are significantly reduced and phone, email, text messaging, online consultations were preferred as communication channels. Before the pandemic, 76% of respondents most often communicated with their physicians by visiting their practice, during the pandemic their relative share decreased to 46%, with a significant difference of 30% Phone consultations: patients using this type of communication increasing from 38% before the pandemic to 56% during the pandemic, a significant difference of 18% The percentage of patients who communicated via text or email rises from 10% to 17 %. It has become apparent that Digital transformation is needed and patients and physicians should work together to achieve it and to be established in Bulgaria. 245 patients reported a change in their treatment. Of these: (30%) reduced the dose of their medications, 119 (49%) increased the dose and the remaining 55 (21%) stopped their therapy. From the responses of the respondents, it is clear that 71% have not experienced a change in their work during the COVID-19 pandemic, 17% have worked from home. From the responses of the respondents, it is clear that 71% have not experienced a change in their work during the COVID-19 pandemic, 17% have worked from home, 4% have been fired, 3% have left their jobs due to the risk of their health and 5% left their jobs for other reasons. <h3>Conclusion</h3> The Covid-19 pandemic has shown that the digital transformation in rheumatology care can be an efficient alternative to some of the services offered to patients with rheumatic diseases in Bulgaria (especially secondary examinations and therapy monitoring examinations). The results of the conducted survey could be used to support digitization in healthcare in Bulgaria. Very important was the collaboration between the patient organizations and the Bulgarian Association for Musculoskeletal Ultrasound, Medical University, Plovdiv and the rheumatologists from University hospital "Kaspela" Plovdiv. <h3>References</h3> [1]Gianfrancesco M, Hyrich KL, Al-Adely S, et al. Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry. Ann Rheum Dis 2020; 79: 859–66. [2]Monti S, Balduzzi S, Delvino P, Bellis E, Quadrelli VS, Montecucco C. Clinical course of COVID-19 in a series of patients with chronic arthritis treated with immunosuppressive targeted therapies. Ann Rheum Dis 2020; 79: 667–68. [3]Dejaco, C.; Alunno, A.; Bijlsma, J.W.; Boonen, A.; Combe, B.; Finckh, A.; Machado, P.M.; Padjen, I.; Sivera, F.; Stamm, T.A.; et al. Influence of COVID-19 pandemic on decisions for the management of people with inflammatory rheumatic and musculoskeletal diseases: A survey among EULAR countries. Ann. Rheum. Dis. 2020 <h3>Acknowledgements</h3> Bulgarian organization for people with rheumatic diseases. Association for patients with autoimmune diseases. Bulgarian Association for Musculoskeletal Ultrasound. <h3>Disclosure of Interests</h3> None Declared.